Abstract:
:Great pathophysiological significance has recently been placed on the association of metabolic abnormalities, such as hyperinsulinemia, insulin resistance, obesity, and frank diabetes mellitus, with essential hypertension and coronary artery disease, and the clinical coincidence of these features has been termed "syndrome X." Despite the suggestion that insulin itself mediates this clinical linkage, the specific mechanisms underlying this syndrome remain poorly understood. We have attempted to understand these phenomena at the cellular level, and have investigated the role of cellular mineral ion species such as cytosolic free calcium (Cai), free magnesium (Mgi), and intracellular pH (pHi) in various insulin resistant states, including essential hypertension, obesity, and type II (non-insulin-dependent) diabetes mellitus (NIDDM). Utilizing nuclear magnetic resonance spectroscopic techniques to noninvasively assess intracellular concentrations of these ions, we observed that each of these disease states is characterized, in whole or in part, by common abnormalities of cellular ion metabolism, including elevated Cai levels and suppressed levels of Mgi and pHi. Furthermore, despite the predominant use of red cells as a tissue source, the measured levels of Cai, Mgi, and pHi were closely related to the ambient blood pressure, the degree of cardiac hypertrophy, and to the hyperinsulinemic response to oral glucose challenge. Altogether, these data suggest an integrated "ionic hypothesis" in which the frequent clinical coexistence of hypertension and altered insulin metabolism derives from common abnormalities of cellular ion handling, resulting in excess steady-state levels of Cai, reciprocal depletion of Mgi, and lowered pHi. These cellular ion alterations would be expected to have tissue-specific consequences, appearing in vascular tissue as vasoconstriction and elevated blood pressure, in skeletal muscle and fat as insulin resistance, in pancreatic beta-cells as hyperinsulinemia, and in neural tissue as potentiated neurotransmitter release and increased sympathetic nerve activity. Thus, according to this hypothesis, essential hypertension, insulin resistance, hyperinsulinemia, and NIDDM are in reality different clinical components of what should be better designated as "generalized cardiovascular-metabolic disease" (GCMD).
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Resnick LMdoi
10.1093/ajh/6.4s.123ssubject
Has Abstractpub_date
1993-04-01 00:00:00pages
123S-134Sissue
4eissn
0895-7061issn
1941-7225pii
0895-7061(93)90335-Jjournal_volume
6pub_type
杂志文章,评审abstract:BACKGROUND:Uncontrolled treatment-resistant hypertension (TRH), i.e., blood pressure (BP, mm Hg) ≥140/≥90mm Hg in and out of office on ≥3 different BP medications at optimal doses, is common and has a poor prognosis. Aldosterone antagonist (AA) and renin-guided therapy (RGT) are effective strategies for improving BP co...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw016
更新日期:2016-08-01 00:00:00
abstract::Plasma renin activity (PRA) declines with age in normal individuals, but the effect of age on plasma angiotensin II (ANG II) is less clear. A decline in plasma ANG II with age could result in altered platelet ANG II receptor density since plasma hormone levels influence their target organ receptors. To investigate thi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.10.687
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:We aimed to assess the predictive value of circulating levels of des-acyl ghrelin, an abundant form of ghrelin in humans, for the risk of cardiovascular disease (CVD) in older hypertensive patients. We simultaneously evaluated other biomarkers, such as high-molecular-weight (HMW) adiponectin, high-sensitivit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt232
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Hypertensive disorders of pregnancy, including preeclampsia (PE), affect approximately 7-10% of pregnancies in the US. Clinical and experimental studies strongly suggest that the maternal immune system plays a role in the development of these disorders; however, few therapeutic options exist aside from deliv...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.125
更新日期:2009-10-01 00:00:00
abstract::Using a new ion selective electrode (ISE) to measure ionized magnesium (IMg2+), we compared levels of IMg2+ with total magnesium (TMg) and serum ionized calcium levels (ICa2+) in umbilical arterial and venous serum of 13 parturients who developed transient hypertension in labor with levels in 38 who remained normotens...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.6.542
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Recent reports suggesting that primary aldosteronism (PA) is more common than historically thought have often relied on use of the plasma aldosterone concentration (PAC) to plasma renin activity (PRA) ratio (ARR) to identify patients with PA. Prior determinations of the validity of the ARR had been generally...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.01.002
更新日期:2005-06-01 00:00:00
abstract::It is known that calcium induces the formation of potent vasodilators in endothelial cells and vasoconstriction in smooth muscle cells, whereas in the renal parenchyma, it modulates sodium excretion through vascular and tubular mechanisms. Consequently, an increased concentration of calcium in renal circulation may in...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.7.473s
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:The role of pulsatile hemodynamics in the management of patients with acute heart failure syndrome (AHFS) remains to be elucidated. We investigated the changes of the pulsatile hemodynamics along the hospital course of AHFS in relation to short-term outcomes. METHODS:A total of 80 AHFS patients (73.2 ± 14.1...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.26
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Schlager inbred hypertensive mice (BPH/2J) have been suggested to have high blood pressure (BP) due to an overactive sympathetic nervous system (SNS). The brain nuclei associated with the hypertension are also those involved in the integration of the cardiovascular responses to stress. Therefore, in the pres...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.69
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Hypertension and smoking independently contribute to the risk of stroke. Our objective was to investigate home blood pressure (HBP) levels, day-by-day BP variability, and smoking in the prediction of stroke in Japanese men. METHODS:In this study, 902 men (mean age, 58.6 years) without a past history of stro...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.62
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:On the basis of evidence of plasma leptin (LE) effects on cardiovascular system, we assessed possible association of LE and Doppler-derived left ventricular (LV) diastolic function in arterial hypertension. METHODS:Doppler echocardiography, blood sample for fasting plasma LE levels, and euglycemic hyperinsu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02137-9
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:We examined the associations of epithelial sodium channel (ENaC) genes with blood pressure (BP) changes and hypertension incidence in a longitudinal family study. METHODS:A total of 2,755 Han Chinese participants of the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) baseline examination were eli...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu060
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:We examined data from a cohort of Caucasian women for evidence of an association between serum vitamin D (25-hydroxyvitamin D (25(OH)D)) insufficiency and greater risk of systolic hypertension in the population-based longitudinal Michigan Bone Health and Metabolism Study (MBHMS). METHODS:The cohort includes...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.226
更新日期:2011-03-01 00:00:00
abstract::It has been suggested that atheroma formation is a chronic inflammatory response to lipid-derived inflammatory mediators accumulating at selected arterial sites. At large artery flow dividers and curvatures, secondary flow phenomena create zones of stagnation and recirculation that deprive endothelial cells of shear s...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/6.11.328s
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Endothelium-dependent vascular relaxation is impaired in various disease states including hypertension. METHODS:We investigated whether a single bolus dose of clofibrate could rapidly reverse saline-induced endothelial dysfunction, in vivo, in salt-loaded Sprague-Dawley (S-D) rats. S-D rats, 5 weeks of age,...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.04.005
更新日期:2006-11-01 00:00:00
abstract::Concentrations of sodium-transport inhibitors (STI) which block the sodium-potassium-ATPase pump are increased in the plasma and urine of volume-expanded and low-renin hypertensive humans and animals. To evaluate the physiologic relevance of STI to blood-pressure-raising mechanisms, we have examined the in vitro prope...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.10.754
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:This study investigates the effects of chronic administration of omapatrilat (OMA) on blood pressure (BP), renal injury, and other variables in N(omega)-nitro-L-arginine methyl ester (L-NAME) hypertension and in the low-renin model produced by the simultaneous administration of L-NAME and deoxycorticosterone...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)03144-8
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Hydrogen sulfide (H2S) is an important endogenous gaseous transmitter in many physiological functions. Plasma H2S decreased, and angiotensin II (Ang II) type 1 receptor (AT1R) increased in the myocardial tissues in 2-kidney 1-clip (2K1C) rats than in normotensive rats. Accumulating evidences suggest that H2S...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw104
更新日期:2017-01-01 00:00:00
abstract::Increased dietary sodium intake has been associated with an increase in blood pressure as well as a decrease in insulin-mediated glucose disposal in young healthy adults. The purpose of this study was to determine whether dietary sodium intake is associated with changes in oral glucose tolerance, insulin sensitivity, ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00159-3
更新日期:1997-09-01 00:00:00
abstract::Stroke-prone spontaneously hypertensive rats (SHRSP), subjected to high NaCl, show severe hypertension, organ damage, and early death. Preventive treatment with angiotensin II type 1 (AT1) receptor antagonists is known to be effective. Previously, we found that angiotensin converting enzyme (ACE) inhibition could redu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01231-0
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:We investigated the effects of percutaneous transluminal renal angioplasty on left ventricular (LV) mass, and the impact of LV mass reduction on outcomes. METHODS:A total of 144 hypertensive patients with renal artery stenosis (RAS) (mean age 69 years; 22.2% fibromuscular dysplasia (FMD)) who underwent angi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa036
更新日期:2020-05-21 00:00:00
abstract::Several epidemiological and clinical studies have established a clear association between alcohol consumption and hypertension. The mechanism of the pressor effect of ethanol is not well understood. We studied the in vitro effects of increasing amounts of ethanol on different Na+ transport systems from human erythrocy...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.10.784
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:Elevated blood pressure (BP) is a risk factor for cardiovascular disease (CVD), but it remains unclear which component-alone or in combination-is the best predictor. We sought to determine which BP parameters are important predictors of CVD death across a wide age range. METHODS:We used a prospective cohort...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.06.024
更新日期:2006-01-01 00:00:00
abstract::In many reports, the prevalence of target organ damage in renovascular hypertension (RVH) appears to be higher than in essential hypertension (EH). Since in most studies the renal artery stenosis is part of a diffuse atherosclerotic disease, it is not known whether these complications are due to RVH itself or to the v...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(96)00199-9
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:The morbidity and mortality benefits of blood pressure (BP) control for the elderly is well documented. The cognitive consequences of hypertension control in this population, however, are still under debate. We aim to study the association between BP and cognitive performance in the elderly. Specifically, we...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)01005-7
更新日期:2003-10-01 00:00:00
abstract::The regulation of atrial natriuretic peptide (ANP) synthesis within cardiac atrial myocytes was investigated in 8 patients undergoing cardiac surgery (valve replacement or coronary bypass graft). Hemodynamic data were obtained during cardiac catheterization and venous plasma samples for ANP were withdrawn prior to sur...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.3.234
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Nifedipine has been reported to cause impairment of insulin sensitivity. But recently a controlled-released formulation of nifedipine (nifedipine-GITS) has been reported that it could improve insulin sensitivity. METHODS:We evaluated insulin sensitivity in two groups of essential hypertensive subjects befor...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0895-7061(02)03019-4
更新日期:2002-11-01 00:00:00
abstract::Mesangial cells in the glomerulus have several important physiological functions, as has been demonstrated by past research. Platelet derived growth factor, thrombin, endothelin, and angiotensin II have all been shown to affect mesangial cell growth and protein synthesis. First generation Ca channel blockers also have...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::We investigated the effects of 17 beta-estradiol (beta E2), alpha-estradiol (alpha E2), and progesterone (P) on baseline and vasopressin (AVP)-induced [Ca2+]i in human platelets obtained from healthy male and female volunteers. Platelets were treated with beta E2, alpha E2, P, or ethanol vehicle for 30 min at 37 degre...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(94)00168-B
更新日期:1995-02-01 00:00:00
abstract::Post-transplant hypertension remains an important risk factor for cardiovascular mortality and graft function. There are multiple mechanisms responsible for post-transplant hypertension. The details of these mechanisms are poorly understood. Steroids, acute and chronic rejection, recurrent renal disease, native kidney...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/3.9.721
更新日期:1990-09-01 00:00:00